This presentation discusses anal fissure, which is a tear in the anal canal. Conservative treatments include nitric oxide, glyceryl trinitrate ointment, and laxatives. Surgical treatments include lateral internal sphincterotomy, anal advancement flap, and dorsal fissurectomy with sphincterotomy. Lateral internal sphincterotomy involves making an incision in the internal sphincter to lower resting pressure and can be done using open or closed techniques. The goal is to divide the lower one third to one half of the internal sphincter. References included textbooks and online sources.

1. Wellcome to topic presentation
Dr. A. B. M. Sadequr Rahman
TAIRUNNESSA MEMORIAL MEDICAL
COLLEGE & HOSPITAL

2. Anal fissure

3. tear

13. -Nitric oxide
-Glyceryl trinitrate ointment 0.2 %
-Laxatives

14. Lateral internal sphincterotomy.
Anal advancement flap.
Dorsal fissurectomy and spingterotomy.

15. Lateral internal sphincterotomy.
Open technique : Involves making an incision across the
intersphincteric groove, separating the internal sphincter
from the anal mucosa by blunt dissection,
and dividing the internal sphincter using scissors.
Closed technique :Involves making a small incision at the
intersphincteric groove, inserting a scalpel with the blade
parallel to the internal sphincter and advancing it along the
intersphincteric groove, and then rotating the scalpel
towards the internal sphincter and dividing it.

16. In both techniques the lower one third to one half of the
internal sphincter is divided, to lower the resting
pressure without destroying the effect of the sphincte
Lateral internal sphincterotomy.

17. Reference
1. Bailey & Love's Short Practice of Surgery 27th E
2. Clinical Surgery 3rd E by Michael M Henry & JEREMY N.THOMPSON
3. https://en.wikipedia.org/wiki/Haemorrhoids
4. https://en.wikipedia.org/wiki/analfissure

18. THANK YOU